SIMPLIFIER.NET - FHIRPath Playground

FHIRPath

If you Log in or sign up, you can edit this script yourself.

{
  "resourceType": "Questionnaire",
  "id": "17e05ce5-651a-49c9-aecd-c14bc9d4dc23",
  "meta": {
    "versionId": "97",
    "lastUpdated": "2022-03-22T13:13:50+00:00"
  },
  "text": {
    "status": "empty",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">No human-readable text provided in this case.</div>"
  },
  "url": "http://health.gov.on.ca/sadie/fhir/FlexForm/HealthStatusReport/Version1",
  "identifier": [
    {
      "use": "official",
      "system": "http://health.gov.on.ca/sadie/fhir/ValueSet/ODSP-Questionnaires",
      "value": "HSR"
    }
  ],
  "name": "HealthStatusReport",
  "title": "Health Status Report",
  "status": "active",
  "experimental": false,
  "subjectType": [
    "Patient"
  ],
  "publisher": "ODSP",
  "effectivePeriod": {
    "start": "2021-06-14T05:00:00Z"
  },
  "code": [
    {
      "system": "https://health.gov.on.ca/sadie/fhir/CodeSystem/FlexForms-Internal-Complete",
      "code": "DocumentType",
      "display": "DDP"
    },
    {
      "system": "https://health.gov.on.ca/sadie/fhir/CodeSystem/FlexForms-Internal-Complete",
      "code": "DocumentSubType",
      "display": "HSR"
    }
  ],
  "item": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/questionnaire-item-control",
                "code": "header",
                "display": "Header"
              }
            ],
            "text": "Header"
          }
        }
      ],
      "linkId": "0",
      "text": "General",
      "type": "group",
      "required": false,
      "repeats": false,
      "readOnly": false,
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
              "valueCode": "display-in-progress"
            }
          ],
          "linkId": "attachment_error_guide_general",
          "text": "If you encounter an upload error or failure, please try again or fax the attachment to the Disability Adjudication Unit at 416-326-3374. The fax must include the client's first and last name, Member ID and Referral ID on the document or fax cover page.",
          "type": "display",
          "required": false,
          "repeats": false,
          "readOnly": false
        },
        {
          "linkId": "0.1",
          "text": "Health Care Professional Details",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "0.1.1",
              "text": "Profession/Specialty",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 100
            }
          ]
        },
        {
          "linkId": "0.2",
          "text": "Applicant's Social Assistance Identification",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "0.2.1",
              "text": "Important: Member ID and referral ID are provided to ODSP applicants by their caseworkers. The ID's can be found at the top of your applicant's paper Disability Determination Package Forms. If your patient does not have an application started with the ministry, you cannot complete this form.",
              "type": "display",
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "[0-9]*"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minLength",
                  "valueInteger": 9
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                  "valueString": "Matches*%context.item.where(linkId='0').item.where(linkId='0.2').item.where(linkId='odsp-member-id-referral-id').answer.valueString='fail'*errors.id.invalid"
                }
              ],
              "linkId": "odsp-member-id",
              "definition": "https://www.hl7.org/fhir/patient-definitions.html#Patient.identifier[1].value",
              "text": "Member ID (9 digits)",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 9
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "[0-9]*"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minLength",
                  "valueInteger": 12
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                  "valueString": "Matches*%context.item.where(linkId='0').item.where(linkId='0.2').item.where(linkId='odsp-member-id-referral-id').answer.valueString='fail'*errors.id.invalid"
                }
              ],
              "linkId": "odsp-referral-id",
              "definition": "https://www.hl7.org/fhir/servicerequest-definitions.html#ServiceRequest.identifier[1].value",
              "text": "Referral ID (12 to 16 digits)",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 16
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                  "valueString": "IDValidator*DocumentReference?type=ODSP-Referral-Record&identifier:urn:sadie:request:odsp=%1%&identifier:urn:sadie:patient:odsp=%2%"
                },
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
                  "valueExpression": {
                    "description": "Member ID and Referral ID concatenation",
                    "language": "text/fhirpath",
                    "expression": "iif(%context.item.where(linkId='0').item.where(linkId='0.2').item.where(linkId='odsp-member-id').answer.valueString.exists() and %context.item.where(linkId='0').item.where(linkId='0.2').item.where(linkId='odsp-referral-id').answer.valueString.exists(), %context.item.where(linkId='0').item.where(linkId='0.2').item.where(linkId='odsp-member-id').answer.valueString + '*' + %context.item.where(linkId='0').item.where(linkId='0.2').item.where(linkId='odsp-referral-id').answer.valueString)"
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "^[0-9]{9}\\*{1}[0-9]{12,16}$"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                  "valueBoolean": true
                }
              ],
              "linkId": "odsp-member-id-referral-id",
              "definition": "https://www.hl7.org/fhir/patient-definitions.html#Patient.identifier[1].value",
              "text": "Member ID + Referral ID (hidden field for validation purpose)",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 26
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
                  "valueCode": "display-error"
                }
              ],
              "linkId": "odsp-member-id-referral-id-display-error",
              "text": "The referral ID and member ID combination you entered is invalid.<br/>Note: These ID's can be found at the top of the paper DDP forms. If you do not have access to this information, please contact your patient who can contact their ODSP caseworker to confirm the ID's. Requests with invalid combination ID's cannot be submitted.",
              "type": "display",
              "enableWhen": [
                {
                  "question": "odsp-member-id-referral-id",
                  "operator": "=",
                  "answerString": "fail"
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
                  "valueCode": "display-success"
                }
              ],
              "linkId": "odsp-member-id-referral-id-display-success",
              "text": "The referral ID and member ID combination you entered is valid.",
              "type": "display",
              "enableWhen": [
                {
                  "question": "odsp-member-id-referral-id",
                  "operator": "=",
                  "answerString": "success"
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
                  "valueCode": "display-error"
                }
              ],
              "linkId": "odsp-member-id-referral-id-display-system-error",
              "text": "There was a problem verifying the Member ID and Referral ID. Please enter the values again.",
              "type": "display",
              "enableWhen": [
                {
                  "question": "odsp-member-id-referral-id",
                  "operator": "=",
                  "answerString": "error"
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
                  "valueCode": "display-in-progress"
                }
              ],
              "linkId": "odsp-member-id-referral-id-display-in-progress",
              "text": "Please wait while Referral ID and Member ID are validated.",
              "type": "display",
              "enableWhen": [
                {
                  "question": "odsp-member-id-referral-id",
                  "operator": "=",
                  "answerString": "in-progress"
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            }
          ]
        },
        {
          "linkId": "0.3",
          "text": "Applicant Forms",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "0.3.1",
              "text": "Do you have a \"Consent to the Release of Medical and Related Information\" form to attach?",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "0.3.1-help",
                  "text": "Very important: If 'No', please ensure the applicant sends their completed/signed Consent form directly to the DAU. Missing information may impact adjudication timelines.",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "0.3.2",
              "text": "Attach your patient's consent form.",
              "type": "attachment",
              "enableWhen": [
                {
                  "question": "0.3.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "0.3.2-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "DDP"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "0.3.2-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Consent"
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "0.3.3",
              "text": "Do you have a \"Client Self Report Form\" to attach?",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "0.3.4",
              "text": "Attach your patient's Self Report form.",
              "type": "attachment",
              "enableWhen": [
                {
                  "question": "0.3.3",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "enableBehavior": "any",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "0.3.4-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "DDP"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "0.3.4-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Self Report"
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/questionnaire-item-control",
                "code": "header",
                "display": "Header"
              }
            ],
            "text": "Header"
          }
        }
      ],
      "linkId": "1",
      "text": "Applicant",
      "type": "group",
      "required": false,
      "repeats": false,
      "readOnly": false,
      "item": [
        {
          "linkId": "1.1",
          "text": "Applicant's Information",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "1.1.1",
              "type": "group",
              "repeats": false,
              "item": [
                {
                  "linkId": "1.1.1.1",
                  "text": "Specify the requested patient information:",
                  "type": "display",
                  "required": false,
                  "repeats": false,
                  "readOnly": false
                },
                {
                  "linkId": "patient-first-name",
                  "definition": "https://www.hl7.org/fhir/patient-definitions.html#Patient.name.given",
                  "text": "First Name",
                  "type": "string",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 25
                },
                {
                  "linkId": "1.1.1.2",
                  "text": "Middle Initial",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 2
                },
                {
                  "linkId": "patient-last-name",
                  "definition": "https://www.hl7.org/fhir/patient-definitions.html#Patient.name.family",
                  "text": "Last Name",
                  "type": "string",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 25
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today()"
                          }
                        }
                      ]
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today() - 200 year"
                          }
                        }
                      ]
                    }
                  ],
                  "linkId": "patient-date-of-birth",
                  "definition": "https://www.hl7.org/fhir/patient-definitions.html#Patient.birthDate",
                  "text": "Date of Birth",
                  "type": "date",
                  "required": true,
                  "repeats": false,
                  "readOnly": false
                }
              ]
            }
          ]
        },
        {
          "linkId": "1.2",
          "text": "Applicant's Current Address",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "[A-Za-z0-9]*"
                }
              ],
              "linkId": "1.2.1",
              "text": "Unit Number",
              "type": "string",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 10
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "[0-9]*"
                }
              ],
              "linkId": "1.2.2",
              "text": "Street Number",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 10
            },
            {
              "linkId": "1.2.3",
              "text": "Street Name",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 25
            },
            {
              "linkId": "1.2.4",
              "text": "City/Town",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 25
            },
            {
              "linkId": "1.2.5",
              "text": "Province",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 25
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minLength",
                  "valueInteger": 6
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "[A-Za-z][0-9][A-Za-z] ?[0-9][A-Za-z][0-9]"
                }
              ],
              "linkId": "1.2.6",
              "text": "Postal Code",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 6
            }
          ]
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/questionnaire-item-control",
                "code": "header",
                "display": "Header"
              }
            ],
            "text": "Header"
          }
        }
      ],
      "linkId": "2",
      "text": "Form",
      "type": "group",
      "required": false,
      "repeats": false,
      "readOnly": false,
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
              "valueCode": "display-in-progress"
            }
          ],
          "linkId": "attachment_error_guide_form",
          "text": "If you encounter an upload error or failure, please try again or fax the attachment to the Disability Adjudication Unit at 416-326-3374. The fax must include the client's first and last name, Member ID and Referral ID on the document or fax cover page.",
          "type": "display",
          "required": false,
          "repeats": false,
          "readOnly": false
        },
        {
          "linkId": "2.1",
          "text": "1. Medical Conditions that Contribute to the Applicant's Current Status",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                  "valueBoolean": true
                }
              ],
              "linkId": "details",
              "definition": "https://www.hl7.org/fhir/servicerequest-definitions.html#ServiceRequest.orderDetail[0].text",
              "type": "string",
              "initial": [
                {
                  "valueString": "Health Status Report"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                  "valueBoolean": true
                },
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
                  "valueExpression": {
                    "description": "ODSP Referral Id",
                    "language": "text/fhirpath",
                    "expression": "%context.item.where(linkId='0').item.where(linkId='0.2').item.where(linkId='odsp-referral-id').answer.valueString"
                  }
                }
              ],
              "linkId": "additional-details",
              "definition": "https://www.hl7.org/fhir/servicerequest-definitions.html#ServiceRequest.orderDetail[1].text",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
                  "valueCode": "display"
                }
              ],
              "linkId": "2.1.1",
              "text": "Please provide information below.",
              "type": "choice",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassLegend"
            },
            {
              "linkId": "2.1.2",
              "text": "Provide information about the applicant's medical conditions, associated impairments, durations and restrictions",
              "type": "group",
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.1.2-help",
                  "text": "To add additional conditions or associated impairments, click on the '+' button",
                  "type": "display"
                },
                {
                  "linkId": "2.1.2.1",
                  "text": "Medical Condition",
                  "type": "text",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 100
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Describe associated impairment(s)",
                  "type": "text",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 500,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "help",
                                "display": "Help-Button"
                              }
                            ],
                            "text": "Help-Button"
                          }
                        }
                      ],
                      "linkId": "2.1.2.2-help",
                      "text": "Refers to any loss or deviation in psychological, physiological or anatomical structure or function.",
                      "type": "display"
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.3",
                  "text": "Describe associated restriction(s)",
                  "type": "text",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 500,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "help",
                                "display": "Help-Button"
                              }
                            ],
                            "text": "Help-Button"
                          }
                        }
                      ],
                      "linkId": "2.1.2.1.3-help",
                      "text": "Refers to a limitation in activities of daily living caused directly by the impairment.",
                      "type": "display"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "radio-button",
                            "display": "Radio Button"
                          }
                        ],
                        "text": "Radio Button"
                      }
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "vertical"
                    }
                  ],
                  "linkId": "2.1.2.4",
                  "text": "Prognosis - condition is likely to:",
                  "type": "choice",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-PrognosisTypes"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "radio-button",
                            "display": "Radio Button"
                          }
                        ],
                        "text": "Radio Button"
                      }
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "vertical"
                    }
                  ],
                  "linkId": "2.1.2.5",
                  "text": "Duration of impairment",
                  "type": "choice",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-Durations"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "radio-button",
                            "display": "Radio Button"
                          }
                        ],
                        "text": "Radio Button"
                      }
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "vertical"
                    }
                  ],
                  "linkId": "2.1.2.6",
                  "text": "Frequency of impairment(s) - are the impairments:",
                  "type": "choice",
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-RecurrentTypes"
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.2",
          "text": "2. Additional Information",
          "type": "group",
          "repeats": false,
          "item": []
        },
        {
          "linkId": "2.1.0",
          "text": "2.1",
          "type": "group",
          "repeats": false,
          "item": [
            {
              "linkId": "2.2.0",
              "text": "Indicate whether any of the medical conditions reported in section 1 include conditions described below.",
              "type": "display",
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.2.1",
              "text": "Mental health condition",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.2.2",
              "text": "Substance-related or addictive disorder",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.2.3",
              "text": "Neurodevelopmental disorder (e.g., intellectual disability, autism spectrum disorder, developmental delay, specific learning disability, attention-deficit/hyperactivity disorder, Fetal Alcohol Spectrum Disorder",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.2.4",
              "text": "Other medical condition presenting with a mental or cognitive impairment (e.g., traumatic brain injury, stroke, seizure disorder)",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.2.5",
              "text": "If there is additional information that might be useful in understanding the applicant's mental or cognitive impairments please describe or attach copies of available reports (e.g., psychology, psychiatry, educational assessment, individual education plan, neuropsychological assessment, other mental health consult).",
              "type": "text",
              "required": false,
              "repeats": true,
              "readOnly": false,
              "maxLength": 8000,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.2.5-help",
                  "text": "Relevant additional information may include: History, interventions, access to treatment, services, housing, homelessness, etc. that might be useful to understand the presenting impairments and their impact.",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "2.2.6",
              "text": "Attach related documents",
              "type": "attachment",
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.2.6-categories",
                  "text": "Attachment Categories",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.2.6-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "AMI"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.2.6-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Regular or IR AMI"
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.3",
          "text": "2.2 Intellectual and Emotional Wellness ",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "2.3.1b",
              "text": "Intellectual and Emotional Wellness Scale (IEWS)",
              "type": "display",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.3.1b-help",
                  "text": "The list below consists of some features or symptoms that might be seen in mental health, substance use, neurocognitive and related conditions that can impact daily functioning. Rate the symptoms in the context of the applicant's presenting conditions and impairments. For episodic symptoms, please describe how fluctuations in the severity level affect the patient.",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "table",
                        "display": "Group table"
                      }
                    ],
                    "text": "Group table"
                  }
                }
              ],
              "linkId": "2.3.2",
              "type": "group",
              "repeats": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
                      "valueCode": "display"
                    }
                  ],
                  "linkId": "2.3.2.1",
                  "text": "Rating Scale",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClass"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.2",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.2.1",
                      "text": "Amotivation",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.3",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.3.1",
                      "text": "Anxiety",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.4",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.4.1",
                      "text": "Appetite Change",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.4').item.where(linkId='2.3.2.4.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.4').item.where(linkId='2.3.2.4.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.4').item.where(linkId='2.3.2.4.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.4.2",
                      "text": "How has the appetite changed?",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-IncreaseDecrease"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.5",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.5.1",
                      "text": "Attention deficit",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.6",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.6.1",
                      "text": "Comprehension deficit",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.7",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.7.1",
                      "text": "Concentration deficit",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.8",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.8.1",
                      "text": "Delusions",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.9",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.9.1",
                      "text": "Depressive mood",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.10",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.10.1",
                      "text": "Disinhibition",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.11",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.11.1",
                      "text": "Disorientation (person, place or time)",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.12",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.12.1",
                      "text": "Dissociative symptoms",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.13",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.13.1",
                      "text": "Emotional dysregulation",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.14",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.14.1",
                      "text": "Energy change",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.14').item.where(linkId='2.3.2.14.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.14').item.where(linkId='2.3.2.14.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.14').item.where(linkId='2.3.2.14.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.14.2",
                      "text": "How has the energy changed?",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-IncreaseDecrease"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.15",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.15.1",
                      "text": "Euphoria/Elation (elevated mood)",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.16",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.16.1",
                      "text": "Executive function deficits (e.g., self-regulation, planning and organization)",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.17",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.17.1",
                      "text": "Grandiosity",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.18",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.18.1",
                      "text": "Hallucination",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.19",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.19.1",
                      "text": "Impulse control deficit",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.20",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.20.1",
                      "text": "Insight deficit",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.21",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.21.1",
                      "text": "Judgement deficit",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.22",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.22.1",
                      "text": "Learning deficits",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.22').item.where(linkId='2.3.2.22.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.22').item.where(linkId='2.3.2.22.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.22').item.where(linkId='2.3.2.22.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.22.2",
                      "text": "Describe the learning deficits:",
                      "type": "text",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 200
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.23",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.23.1",
                      "text": "Memory deficit",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check box"
                              }
                            ],
                            "text": "Check box"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.23').item.where(linkId='2.3.2.23.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.23').item.where(linkId='2.3.2.23.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.23').item.where(linkId='2.3.2.23.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.23.2",
                      "text": "Memory Deficit - select all that apply: ",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-MemoryImpairments"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.24",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.24.1",
                      "text": "Psychomotor retardation",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.24').item.where(linkId='2.3.2.24.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.24').item.where(linkId='2.3.2.24.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.24').item.where(linkId='2.3.2.24.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.24.2",
                      "text": "Agitation or retardation?",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-Psychomotor"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.25",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.25.1",
                      "text": "Sleep dysfunction",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.25').item.where(linkId='2.3.2.25.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.25').item.where(linkId='2.3.2.25.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.25').item.where(linkId='2.3.2.25.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.25.2",
                      "text": "Difficulty sleeping or excessive sleeping?",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-Sleep"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.26",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.26.1",
                      "text": "Speech deficit (not due to language barrier)",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.26').item.where(linkId='2.3.2.26.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.26').item.where(linkId='2.3.2.26.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.26').item.where(linkId='2.3.2.26.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.26.2",
                      "text": "Specify:",
                      "type": "text",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 200
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.27",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.27.1",
                      "text": "Suicidality",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check box"
                              }
                            ],
                            "text": "Check box"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "%context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.27').item.where(linkId='2.3.2.27.1').answer.valueCoding.code='1' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.27').item.where(linkId='2.3.2.27.1').answer.valueCoding.code='2' or %context.item.where(linkId='2').item.where(linkId='2.3').item.where(linkId='2.3.2').item.where(linkId='2.3.2.27').item.where(linkId='2.3.2.27.1').answer.valueCoding.code='3'"
                          }
                        }
                      ],
                      "linkId": "2.3.2.27.2",
                      "text": "Suicidal behaviours - select all that apply:",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-Suicidal"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.28",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.28.1",
                      "text": "Thought disorganization",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "gtable",
                            "display": "Group gtable"
                          }
                        ],
                        "text": "Group gtable"
                      }
                    }
                  ],
                  "linkId": "2.3.2.29",
                  "type": "group",
                  "repeats": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ],
                            "text": "Radio Button"
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "2.3.2.29.1",
                      "text": "Withdrawn",
                      "type": "choice",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-SymptomClassCodes"
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.3.3",
              "text": "For episodic symptoms, describe how fluctuations in severity level affect the patient",
              "type": "text",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            }
          ]
        },
        {
          "linkId": "2.4",
          "text": "3. Available Medical and Other Information Related to Section 1",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "2.4.1",
              "text": "Note: You do not have to repeat the information already provided in previous sections.",
              "type": "display",
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.4.2",
              "text": "How long have you known the applicant?",
              "type": "string",
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 100,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 3.1"
                      }
                    }
                  ],
                  "linkId": "2.4.2-help",
                  "text": "Section 3.1",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.4.3",
              "text": "How often do you see the applicant for the conditions and/or impairments listed in Section 1?",
              "type": "string",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 100,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 3.2"
                      }
                    }
                  ],
                  "linkId": "2.4.3-help",
                  "text": "Section 3.2",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
                  "valueCoding": {
                    "code": "cm"
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                  "valueInteger": 0
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "^[^eE]*$"
                }
              ],
              "linkId": "2.4.4",
              "text": "If relevant, state the applicant's height in centimetres",
              "type": "decimal",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 255,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 3.3"
                      }
                    }
                  ],
                  "linkId": "2.4.4-help",
                  "text": "Section 3.3",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
                  "valueCoding": {
                    "code": "kg"
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                  "valueInteger": 0
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/regex",
                  "valueString": "^[^eE]*$"
                }
              ],
              "linkId": "2.4.5",
              "text": "If relevant, state the applicant's weight in kilograms",
              "type": "decimal",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 255
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
                  "valueExpression": {
                    "description": "BMI Calculation",
                    "language": "text/fhirpath",
                    "expression": "iif(%context.item.where(linkId='2').item.where(linkId='2.4').item.where(linkId='2.4.4').answer.valueDecimal.exists() and %context.item.where(linkId='2').item.where(linkId='2.4').item.where(linkId='2.4.5').answer.valueDecimal.exists(), (%context.item.where(linkId='2').item.where(linkId='2.4').item.where(linkId='2.4.5').answer.valueDecimal / ((%context.item.where(linkId='2').item.where(linkId='2.4').item.where(linkId='2.4.4').answer.valueDecimal / 100.0) * (%context.item.where(linkId='2').item.where(linkId='2.4').item.where(linkId='2.4.4').answer.valueDecimal / 100.0))).round(1))"
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxDecimalPlaces",
                  "valueInteger": 1
                }
              ],
              "linkId": "2.4.6",
              "text": "Body Mass Index (BMI)",
              "type": "decimal",
              "required": false,
              "repeats": false,
              "readOnly": true,
              "maxLength": 10
            },
            {
              "linkId": "2.4.7",
              "text": "Other relevant Patient details (i.e. Blood Pressure)",
              "type": "string",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 100
            },
            {
              "linkId": "2.4.8",
              "text": "Are there examination findings that you wish to include?",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.4.9",
              "text": "Enter examination findings:",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.4.8",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.4.10",
              "text": "For recurrent or episodic impairments listed, describe how fluctuations in severity level affect the patient.",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.4.8",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.4.11",
              "text": "Have any consultations or assessments been completed by another health care professional?",
              "type": "boolean",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 3.4"
                      }
                    }
                  ],
                  "linkId": "2.4.11-help",
                  "text": "Section 3.4",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.4.12N",
              "text": "Comment (e.g., pending or waiting list, not available)",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": false
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 1000
            },
            {
              "linkId": "2.4.12",
              "text": "Describe diagnostic tests or investigations",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.4.12-help",
                  "text": "For example, laboratory, biopsy, sleep study, ultrasound, imaging, stress test",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "2.4.12-attachment",
              "text": "Attach relevant diagnostic tests or investigations",
              "type": "attachment",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.4.12-categories",
                  "text": "Attachment Categories",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.4.12-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "AMI"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.4.12-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Regular or IR AMI"
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.4.13",
              "text": "Describe specialist consults",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.4.13-help",
                  "text": "For example, cardiology, neurology, oncology, psychiatry, psychology, rheumatology",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "2.4.13-attachment",
              "text": "Attach relevant specialist consults",
              "type": "attachment",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.4.13-categories",
                  "text": "Attachment Categories",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.4.13-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "AMI"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.4.13-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Regular or IR AMI"
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.4.14",
              "text": "Describe other assessments or reports",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.4.14-help",
                  "text": "For example, vocational assessment, occupational therapy report",
                  "type": "display"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "2.4.14-attachment",
              "text": "Attach relevant other assessments or reports",
              "type": "attachment",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.4.14-categories",
                  "text": "Attachment Categories",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.4.14-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "AMI"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.4.14-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Regular or IR AMI"
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.4.15",
              "text": "For recurrent or episodic impairments listed, describe how fluctuations in severity level affect the patient.",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.4.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            }
          ]
        },
        {
          "linkId": "2.5",
          "text": "4. Visual",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "2.5.1",
              "text": "Does the patient have a visual impairment as described in Section 1 of this request?",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today()"
                      }
                    }
                  ]
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today() - 200 year"
                      }
                    }
                  ]
                }
              ],
              "linkId": "2.5.2",
              "text": "Date of Diagnosis (if known) ",
              "type": "date",
              "enableWhen": [
                {
                  "question": "2.5.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today()"
                      }
                    }
                  ]
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today() - 200 year"
                      }
                    }
                  ]
                }
              ],
              "linkId": "2.5.3",
              "text": "Most Recent Assessment Date",
              "type": "date",
              "enableWhen": [
                {
                  "question": "2.5.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.5.5-display",
              "text": "Snellen Visual Acuity Chart Details",
              "type": "display",
              "enableWhen": [
                {
                  "question": "2.5.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "gtable",
                        "display": "Group gtable"
                      }
                    ],
                    "text": "Group gtable"
                  }
                }
              ],
              "linkId": "2.5.5-gtable",
              "type": "group",
              "enableWhen": [
                {
                  "question": "2.5.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "table",
                            "display": "Group table"
                          }
                        ],
                        "text": "Group table"
                      }
                    }
                  ],
                  "linkId": "2.5.5-left-group-table",
                  "type": "group",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "item": [
                    {
                      "linkId": "2.5.5-left-display",
                      "text": "Left eye",
                      "type": "display",
                      "required": false,
                      "repeats": false,
                      "readOnly": false
                    },
                    {
                      "linkId": "2.5.5.2-left",
                      "text": "Uncorrected - Near",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.3-left",
                      "text": "Uncorrected - Distance",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.4-left",
                      "text": "Corrected - Near",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.5-left",
                      "text": "Corrected - Distance",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "table",
                            "display": "Group table"
                          }
                        ],
                        "text": "Group table"
                      }
                    }
                  ],
                  "linkId": "2.5.5-right-group-table",
                  "type": "group",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "item": [
                    {
                      "linkId": "2.5.5-right-display",
                      "text": "Right eye",
                      "type": "display",
                      "required": false,
                      "repeats": false,
                      "readOnly": false
                    },
                    {
                      "linkId": "2.5.5.2-right",
                      "text": "Uncorrected - Near",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.3-right",
                      "text": "Uncorrected - Distance",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.4-right",
                      "text": "Corrected - Near",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.5-right",
                      "text": "Corrected - Distance",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "table",
                            "display": "Group table"
                          }
                        ],
                        "text": "Group table"
                      }
                    }
                  ],
                  "linkId": "2.5.5-both-group-table",
                  "type": "group",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "item": [
                    {
                      "linkId": "2.5.5-both-display",
                      "text": "Both eyes",
                      "type": "display",
                      "required": false,
                      "repeats": false,
                      "readOnly": false
                    },
                    {
                      "linkId": "2.5.5.2-both",
                      "text": "Uncorrected - Near",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.3-both",
                      "text": "Uncorrected - Distance",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.4-both",
                      "text": "Corrected - Near",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    },
                    {
                      "linkId": "2.5.5.5-both",
                      "text": "Corrected - Distance",
                      "type": "string",
                      "required": true,
                      "repeats": false,
                      "readOnly": false,
                      "maxLength": 100
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.5.6",
              "text": "Is there a visual field defect component in the visual impairment?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.5.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.5.7",
              "type": "group",
              "enableWhen": [
                {
                  "question": "2.5.6",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.5.7.1",
                  "text": "Describe the visual field defect of the patient",
                  "type": "display",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "help",
                                "display": "Help-Button"
                              }
                            ],
                            "text": "Help-Button"
                          }
                        }
                      ],
                      "linkId": "2.5.7.1-help",
                      "text": "Please describe the visual field defect component and/or attach reports.",
                      "type": "display"
                    }
                  ]
                },
                {
                  "linkId": "2.5.7.1b",
                  "text": "Visual Field Defect",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 1000
                }
              ]
            },
            {
              "linkId": "2.5.8",
              "text": "Is there a change in ocular mobility (e.g., diplopia, strabismus) or deformities of the orbit that alter function?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.5.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.5.9",
              "type": "group",
              "enableWhen": [
                {
                  "question": "2.5.8",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.5.9.1",
                  "text": "Describe the ocular mobility defect of the patient",
                  "type": "display",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "help",
                                "display": "Help-Button"
                              }
                            ],
                            "text": "Help-Button"
                          }
                        }
                      ],
                      "linkId": "2.5.9.1-help",
                      "text": "Please describe the change in ocular mobility or deformities and/or attach reports.",
                      "type": "display"
                    }
                  ]
                },
                {
                  "linkId": "2.5.9.1b",
                  "text": "Ocular Mobility Defect",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 1000
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "2.5.10",
              "text": "Attach copies of Visual report(s) pertaining to the patient's diagnosis/condition. You may also wish to attach consult notes.",
              "type": "attachment",
              "enableWhen": [
                {
                  "question": "2.5.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.5.10-categories",
                  "text": "Attachment Categories",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.5.10-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "AMI"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.5.10-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Regular or IR AMI"
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.6",
          "text": "5. Auditory",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "2.6.1",
              "text": "Does the patient have an auditory impairment as described in Section 1 of this request?",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today()"
                      }
                    }
                  ]
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today() - 200 year"
                      }
                    }
                  ]
                }
              ],
              "linkId": "2.6.2",
              "text": "Date of Diagnosis (if known)",
              "type": "date",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today()"
                      }
                    }
                  ]
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "today() - 200 year"
                      }
                    }
                  ]
                }
              ],
              "linkId": "2.6.3",
              "text": "Most Recent Assessment Date",
              "type": "date",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "drop down",
                        "display": "Drop down"
                      }
                    ],
                    "text": "Drop down"
                  }
                }
              ],
              "linkId": "2.6.4",
              "text": "What type is the hearing loss?",
              "type": "choice",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-Hearing",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.1"
                      }
                    }
                  ],
                  "linkId": "2.6.4-help",
                  "text": "Section 5.1",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.5",
              "text": "Has there been any change in hearing loss over the last 5 years?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.2"
                      }
                    }
                  ],
                  "linkId": "2.6.5-help",
                  "text": "Section 5.2",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.6",
              "text": "Describe the auditory impairment the patient experienced",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.6.5",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.6.7",
              "text": "Does the applicant have difficulty understanding speech in a quiet environment?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.3"
                      }
                    }
                  ],
                  "linkId": "2.6.7-help",
                  "text": "Section 5.3",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.8",
              "text": "Describe the patient's difficulty understanding speech in a quiet environment.",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.6.7",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.6.9",
              "text": "Does the applicant have difficulty understanding conversational speech in the presence of background noise? ",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.4"
                      }
                    }
                  ],
                  "linkId": "2.6.9-help",
                  "text": "Section 5.4",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.10",
              "text": "Describe the applicant's difficulty understanding conversational speech in the presence of background noise.",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.6.9",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.6.11",
              "text": "Are there safety concerns related to hearing (e.g., unable to localize sound of approaching vehicles)?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.5"
                      }
                    }
                  ],
                  "linkId": "2.6.11-help",
                  "text": "Section 5.5",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.12",
              "text": "Describe the safety concerns related to hearing.",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.6.11",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.6.13",
              "text": "Does the applicant have a constant/annoying ringing (tinnitus) in ears?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.6"
                      }
                    }
                  ],
                  "linkId": "2.6.13-help",
                  "text": "Section 5.6",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.14",
              "text": "Describe the applicant's tinnitus.",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.6.13",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.6.15",
              "text": "Does the applicant wear hearing aids?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.7"
                      }
                    }
                  ],
                  "linkId": "2.6.15-help",
                  "text": "Section 5.7",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.16",
              "text": "Describe the applicant's hearing aids.",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.6.15",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.6.17",
              "text": "With the hearing aid(s), could or can the applicant function within normal limits?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Section 5.8"
                      }
                    }
                  ],
                  "linkId": "2.6.15-help",
                  "text": "Section 5.8",
                  "type": "display"
                }
              ]
            },
            {
              "linkId": "2.6.18",
              "text": "If no, describe",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.6.17",
                  "operator": "=",
                  "answerBoolean": false
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "2.6.19",
              "text": "Attach copies of Auditory report(s) pertaining to the patient's diagnosis/condition. You may also wish to attach consult notes. ",
              "type": "attachment",
              "enableWhen": [
                {
                  "question": "2.6.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.6.19-categories",
                  "text": "Attachment Categories",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.6.19-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "AMI"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.6.19-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Regular or IR AMI"
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.7",
          "text": "6. Intervention and Treatment",
          "type": "group",
          "required": false,
          "repeats": false,
          "readOnly": false,
          "item": [
            {
              "linkId": "2.7.1",
              "text": "6.1 Is the applicant receiving any interventions and treatment for conditions and impairments listed in section 1 (e.g. Admission, Emergency Room Visit, Surgery, Pharmacotherapy, Interventions and Services.)",
              "type": "boolean",
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.7.9",
              "text": "If no, provide additional information: (e.g., pending, side effects, no definitive diagnosis, not available, poor insight)",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.7.1",
                  "operator": "=",
                  "answerBoolean": false
                }
              ],
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 1000
            },
            {
              "linkId": "2.7.2",
              "text": "Does the applicant have any relevant admissions, emergency room visits or surgeries?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.7.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.7.3",
              "text": "Describe admissions, emergency room visits or surgeries, completing relevant sections below and comment on progress.",
              "type": "group",
              "enableWhen": [
                {
                  "question": "2.7.2",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.7.3-help",
                  "text": "To add additional treatments/interventions, click on the '+' button",
                  "type": "display"
                },
                {
                  "linkId": "2.7.3.1",
                  "text": "Admission, Emergency Room Visit or, Surgery",
                  "type": "text",
                  "enableWhen": [
                    {
                      "question": "2.7.2",
                      "operator": "=",
                      "answerBoolean": true
                    }
                  ],
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 4000,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "help",
                                "display": "Help-Button"
                              }
                            ],
                            "text": "Help-Button"
                          }
                        }
                      ],
                      "linkId": "GEN-DH-DRUG-TXT-help",
                      "text": "Describe the nature of the visit (admission, emergency room visit, surgery)",
                      "type": "display"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today()"
                          }
                        }
                      ]
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today() - 200 year"
                          }
                        }
                      ]
                    }
                  ],
                  "linkId": "2.7.3.2",
                  "text": "Date of Visit",
                  "type": "date",
                  "required": false,
                  "repeats": false,
                  "readOnly": false
                },
                {
                  "linkId": "2.7.3.3",
                  "text": "Duration",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 500
                },
                {
                  "linkId": "2.7.3.4",
                  "text": "Describe Purpose or Attach Admission/Discharge Report",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 4000
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/msword"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/rtf"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "image/tiff"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/pdf"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "image/gif"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "vertical"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                      "valueDecimal": 10
                    }
                  ],
                  "linkId": "2.7.3.5",
                  "text": "Discharge Report",
                  "type": "attachment",
                  "required": false,
                  "repeats": true,
                  "readOnly": false,
                  "item": [
                    {
                      "linkId": "2.7.3.5-categories",
                      "text": "Attachment Categories",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                          "valueBoolean": true
                        }
                      ],
                      "linkId": "2.7.3.5-DocumentType",
                      "type": "string",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "initial": [
                        {
                          "valueString": "AMI"
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                          "valueBoolean": true
                        }
                      ],
                      "linkId": "2.7.3.5-DocumentSubType",
                      "type": "string",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "initial": [
                        {
                          "valueString": "Regular or IR AMI"
                        }
                      ]
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.7.6",
              "text": "Does the applicant have any relevant pharmacological interventions?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.7.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.7.7",
              "text": "Describe pharmacological interventions, completing relevant sections below.",
              "type": "group",
              "enableWhen": [
                {
                  "question": "2.7.6",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.7.7-help",
                  "text": "To add additional medications, click on the \"+\" button ",
                  "type": "display"
                },
                {
                  "linkId": "2.7.7.1",
                  "text": "Pharmacotherapy treatment",
                  "type": "text",
                  "enableWhen": [
                    {
                      "question": "2.7.6",
                      "operator": "=",
                      "answerBoolean": true
                    }
                  ],
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 255,
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "help",
                                "display": "Help-Button"
                              }
                            ],
                            "text": "Help-Button"
                          }
                        }
                      ],
                      "linkId": "2.7.7.1-help",
                      "text": "Enter name of pharmacotherapy treatment.",
                      "type": "display"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today()"
                          }
                        }
                      ]
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today() - 200 year"
                          }
                        }
                      ]
                    }
                  ],
                  "linkId": "2.7.7.2",
                  "text": "Start Date (if known)",
                  "type": "date",
                  "required": false,
                  "repeats": false,
                  "readOnly": false
                },
                {
                  "linkId": "2.7.7.3",
                  "text": "Dosage",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 100
                },
                {
                  "linkId": "2.7.7.4",
                  "text": "Frequency",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 500
                },
                {
                  "linkId": "2.7.7.5",
                  "text": "List Conditions or Impairments being treated",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 4000
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/msword"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/rtf"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "image/tiff"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/pdf"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "image/gif"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "vertical"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                      "valueDecimal": 10
                    }
                  ],
                  "linkId": "2.7.7.6",
                  "text": "Attach Report",
                  "type": "attachment",
                  "required": false,
                  "repeats": true,
                  "readOnly": false,
                  "item": [
                    {
                      "linkId": "2.7.7.6-categories",
                      "text": "Attachment Categories",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                          "valueBoolean": true
                        }
                      ],
                      "linkId": "2.7.7.6-DocumentType",
                      "type": "string",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "initial": [
                        {
                          "valueString": "AMI"
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                          "valueBoolean": true
                        }
                      ],
                      "linkId": "2.7.7.6-DocumentSubType",
                      "type": "string",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "initial": [
                        {
                          "valueString": "Regular or IR AMI"
                        }
                      ]
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.7.4",
              "text": "Does the applicant have any relevant interventions or services?",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "2.7.1",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false
            },
            {
              "linkId": "2.7.10",
              "text": "If no, provide additional information: (e.g., pending, side effects, no definitive diagnosis, not available, poor insight)",
              "type": "text",
              "enableWhen": [
                {
                  "question": "2.7.4",
                  "operator": "=",
                  "answerBoolean": false
                }
              ],
              "required": true,
              "repeats": false,
              "readOnly": false,
              "maxLength": 1000
            },
            {
              "linkId": "2.7.5",
              "text": "Describe interventions and services, completing relevant sections below and comment on progress.",
              "type": "group",
              "enableWhen": [
                {
                  "question": "2.7.4",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "required": true,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "help",
                            "display": "Help-Button"
                          }
                        ],
                        "text": "Help-Button"
                      }
                    }
                  ],
                  "linkId": "2.7.5-help",
                  "text": "To add additional interventions and services, click on the \"+\" button",
                  "type": "display"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "drop down",
                            "display": "Drop down"
                          }
                        ],
                        "text": "Drop down"
                      }
                    }
                  ],
                  "linkId": "2.7.5.1",
                  "text": "Interventions and Services",
                  "type": "choice",
                  "enableWhen": [
                    {
                      "question": "2.7.4",
                      "operator": "=",
                      "answerBoolean": true
                    }
                  ],
                  "required": true,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 500,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-Intervention",
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "help",
                                "display": "Help-Button"
                              }
                            ],
                            "text": "Help-Button"
                          }
                        }
                      ],
                      "linkId": "2.7.5.1-help",
                      "text": "Select an intervention or service from the list below:",
                      "type": "display"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                      "valueExpression": {
                        "description": "Show if one of the 'other' options are selected",
                        "language": "text/fhirpath",
                        "expression": "%context.item.where(linkId='2').item.where(linkId='2.7').item.where(linkId='2.7.5')[%repeatingGroupIndex%].item.where(linkId='2.7.5.1').answer.valueCoding.code='Intervention-9'"
                      }
                    }
                  ],
                  "linkId": "2.7.5.1a",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 500
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                      "valueExpression": {
                        "description": "Show if one of the 'other' options are selected",
                        "language": "text/fhirpath",
                        "expression": "%context.item.where(linkId='2').item.where(linkId='2.7').item.where(linkId='2.7.5')[%repeatingGroupIndex%].item.where(linkId='2.7.5.1').answer.valueCoding.code='Intervention-10'"
                      }
                    }
                  ],
                  "linkId": "2.7.5.1b",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 500
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today() + 1 day"
                          }
                        }
                      ]
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today() - 200 year"
                          }
                        }
                      ]
                    }
                  ],
                  "linkId": "2.7.5.2",
                  "text": "Start Date (Approximate start date)",
                  "type": "date",
                  "required": false,
                  "repeats": false,
                  "readOnly": false
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today() + 1 day"
                          }
                        }
                      ]
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
                          "valueExpression": {
                            "language": "text/fhirpath",
                            "expression": "today() - 200 year"
                          }
                        }
                      ]
                    }
                  ],
                  "linkId": "2.7.5.3",
                  "text": "End Date (Approximate end date)",
                  "type": "date",
                  "required": false,
                  "repeats": false,
                  "readOnly": false
                },
                {
                  "linkId": "2.7.5.4",
                  "text": "Describe Response to Treatment",
                  "type": "text",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "maxLength": 4000
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/msword"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/rtf"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "image/tiff"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "application/pdf"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                      "valueCode": "image/gif"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "vertical"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                      "valueDecimal": 10
                    }
                  ],
                  "linkId": "2.7.5.5",
                  "text": "Attach Report",
                  "type": "attachment",
                  "required": false,
                  "repeats": true,
                  "readOnly": false,
                  "item": [
                    {
                      "linkId": "2.7.5.5-categories",
                      "text": "Attachment Categories",
                      "type": "choice",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                          "valueBoolean": true
                        }
                      ],
                      "linkId": "2.7.5.5-DocumentType",
                      "type": "string",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "initial": [
                        {
                          "valueString": "AMI"
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                          "valueBoolean": true
                        }
                      ],
                      "linkId": "2.7.5.5-DocumentSubType",
                      "type": "string",
                      "required": false,
                      "repeats": false,
                      "readOnly": false,
                      "initial": [
                        {
                          "valueString": "Regular or IR AMI"
                        }
                      ]
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.7.8",
              "text": "6.2 Describe any relevant past treatment and reason for discontinuation (e.g., remission, failed treatment, change in treatment, side effects)",
              "type": "text",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 4000
            },
            {
              "linkId": "2.8.1.1",
              "text": "6.3 Provide any other information that might be useful in understanding the applicant's current situation.",
              "type": "text",
              "required": false,
              "repeats": false,
              "readOnly": false,
              "maxLength": 8000
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/msword"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/rtf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/tiff"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "application/pdf"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
                  "valueCode": "image/gif"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
                  "valueDecimal": 10
                }
              ],
              "linkId": "2.8.1.2",
              "text": "Attach related documents here.",
              "type": "attachment",
              "required": false,
              "repeats": true,
              "readOnly": false,
              "item": [
                {
                  "linkId": "2.8.1.2-categories",
                  "text": "Attachment Categories",
                  "type": "choice",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.8.1.2-DocumentType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "AMI"
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                      "valueBoolean": true
                    }
                  ],
                  "linkId": "2.8.1.2-DocumentSubType",
                  "type": "string",
                  "required": false,
                  "repeats": false,
                  "readOnly": false,
                  "initial": [
                    {
                      "valueString": "Regular or IR AMI"
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}

name : HealthStatusReport

{

}